It’s time for clinicians in the blood cancer space to start having those awkward conversations with patients about the impacts of treatment on their sex lives.

The haematology world has largely avoided this important aspect of cancer care much to the detriment of patients who can face profound and long-term changes to their sexual function and fertility as a result of their treatment, Professor Kate White, from the Cancer Nursing Research Unit at the University of Sydney, told the HAA Annual Scientific Meeting held in Sydney this week.

“If you go into the solid tumour space, there is an immediate identification in the clinician’s mind this is going to have an impact on sexual function,” Professor White told the limbic.

“That work hasn’t been done in the haematology setting, but there are things we have learnt that we can translate across.”

To date, most research has focussed on younger male loss of fertility and erectile dysfunction in younger male bone marrow transplant recipients, with little attention placed on the impacts of treatment on older males and female blood cancer survivors, she said.

This is partly due to the high-stakes nature of these diseases which can keep clinicians’ mindset in an acute care framework.

But their reluctance to broach awkward subjects also plays into the equation.

“Every study that’s been done on haematology or solid tumour has identified that medical professionals and nurses find this topic difficult and don’t feel comfortable with it,” she told the limbic.

Side effects for women who have had bone marrow transplants include early menopause or to developing graft-versus-host disease, both of which can impact sexual relationships.

“For some women that can be in the urinary or genital area leading to symptoms that make sexual intercourse virtually impossible and requires ongoing management.

If that becomes chronic, it has a profound impact on that woman’s ability to have a relationship that can then also impact on their relationship with their partners.”

“The approach I take is if you are giving an anti-cancer drug that has side effects, like nausea and hair loss, we have a responsibility as part of our code of practice to ensure they understand those side effects and how to manage them.

“These same drugs can have an impact on sexual function so we have the same professional responsibilty to make them aware of any possible adverse effects on their ability to maintain an intimate relationship,” she said.

“I think we need to raise the awareness on how this impacts on their patients’ quality of life, and take responsibility to make sure someone in the team is routinely assessing and following up patients.”